A 72-year-old man with hypertension and hyperlipidemia presents with sudden onset of severe tearing chest pain radiating to the back. He has a blood pressure of 180/110 mmHg and an aortic regurgitation murmur. A CT angiography shows a dissection of the descending thoracic aorta. Which of the following is the primary acute management goal?
- A)Administer aspirin for cardioprotection
- B)Place an intra-aortic balloon pump for hemodynamic support
- C)Initiate heparin anticoagulation to prevent thromboembolism
- D)Immediately perform emergency aortic repair surgery
- E)Reduce aortic wall stress with blood pressure control and negative inotropic agentsGABARITO
Explicação
Type B aortic dissection (descending thoracic) is initially managed medically with aggressive blood pressure and heart rate reduction using beta-blockers and vasodilators to decrease dP/dt (aortic wall stress). This reduces expansion and rupture risk. Ver explicação completa e trilha adaptativa →